India’s public surveillance blueprint in the face of Chinese epidemics

China’s emergence as a focal point for respiratory illnesses presents a historical twist, echoing its role in past global health events. Notably, China was the epicentre of the SARS outbreak in 2003 and, more recently, the Covid-19 pandemic that began in 2019. These events placed China at the forefront of international public health concerns, prompting global efforts to understand and contain respiratory viruses originating within its borders. In a surprising turn, recent developments in 2023 have once again drawn global attention to China, but this time due to a significant increase in respiratory illnesses among children, particularly in the northern regions. The World Health Organisation (WHO) has been monitoring this surge since mid-October 2023, with the Chinese National Health Commission reporting a nationwide rise in respiratory diseases, predominantly affecting children. This increase is attributed to various factors, including the lifting of COVID-19 restrictions, the arrival of the colder season, and the circulation of known pathogens such as influenza, Mycoplasma pneumoniae, respiratory syncytial virus (RSV) and SARS-CoV-2. Intriguingly, Mycoplasma pneumonia and RSV, which are more commonly seen in children than adults, have been central to this recent spike. in response, the WHO requested detailed information from China to ascertain whether the reported clusters of undiagnosed pneumonia in Beijing and Liaoning were isolated incidents or indicative of a broader trend. Subsequent discussions with Chinese health authorities revealed increased consultations and hospital admissions for Mycoplasma pneumonia and other viruses since May. Despite these developments, Chinese authorities have reported no detection of unusual or novel diseases and have managed to prevent these rising cases from overburdening hospital capacities. The recent outbreak of a respiratory illness in China has raised significant concerns for India and the global community. The primary concern lies in the potential for the rapid spread of the disease to India, given its close proximity to China and the high volume of travel between the two countries. This outbreak serves as a stark reminder of the interconnectedness of the world in the face of infectious diseases. India is rightfully concerned about the possibility of the virus reaching its shores, and the government and public health authorities have been closely monitoring the situation to implement necessary measures to prevent and control the spread of the illness within the country. The experience of dealing with previous epidemics like SARS and H1N1 has informed India’s response, but the evolving nature of the virus and its transmission dynamics necessitate ongoing vigilance and preparedness. India’s public health surveillance system has seen significant improvements over the years, but challenges persist. According to a report published by the WHO in 2021, India has made commendable progress in strengthening its public health surveillance infrastructure. The report noted that India has enhanced its disease reporting mechanisms, expanded its network of laboratories, and improved data collection and analysis. However, it also highlighted issues such as underreporting, limited healthcare access in rural areas, and the need for better integration of data from various sources. To address these challenges, India has implemented initiatives like the Integrated Disease Surveillance Programme (IDSP) and the National Health Mission (NHM) to bolster its public health surveillance capabilities. To further strengthen its public health surveillance program, India should focus on several key areas. Firstly, there should be an increased emphasis on training and capacity-building for healthcare workers and officials at all levels to ensure timely and accurate reporting of diseases. Additionally, investments in upgrading healthcare infrastructure, especially in rural and underserved areas, are essential to improve access to healthcare services and enhance surveillance capabilities. Leveraging technology for data collection, analysis, and reporting can also play a crucial role in improving real-time monitoring and response to outbreaks. Furthermore, international collaboration and information sharing should be encouraged to stay abreast of global health threats. India must also invest in research and development to develop vaccines and treatments for emerging diseases, reducing the overall vulnerability of its population. Overall, a multifaceted approach that combines infrastructure development, capacity-building, technology integration, and global cooperation is essential for strengthening India’s public health surveillance program and ensuring the health and well-being of its population. The NITI Aayog’s “Vision 2035: Public Health Surveillance in India” document outlines a strategic plan for enhancing India’s public health surveillance by 2035. It builds on existing initiatives like Ayushman Bharat, which provides community-level health and wellness centres and reduces out-of-pocket expenses, and the Integrated Disease Surveillance Program’s IHIP. The vision aligns with the citizen-centric approach of the National Health Policy 2017 and the National Digital Health Blueprint, advocating for mobile, digital platforms, and Point-of-Care diagnostics for data integration. Emphasising private sector involvement through the Clinical Establishments Act and coordinated efforts from apex institutions like the National Centre for Disease Control, the document also suggests creating an independent Institute of Health Informatics. It highlights the need to address gaps in public health surveillance, such as integrating non-communicable diseases, reproductive and child health, and environmental health into surveillance systems. Merging morbidity data with mortality statistics, adopting a One-Health approach, enhancing community-based surveillance, and strengthening laboratory capacities with new technologies are also suggested. The white paper proposes four foundational elements: an interdependent governance architecture between the Centre and States, new data collection and sharing mechanisms using comprehensive Electronic Health Records (EHR) with a unique health identifier (UHID), advanced data analytics and health informatics, and leveraging artificial intelligence and machine learning. The plan envisions individual EHRs capturing health data at various healthcare touchpoints, complemented by periodic surveys for disease monitoring and response refinement. A Surveillance Information Platform will be key for storing, analyzing, and generating actionable reports, also serving as a research repository. The document recommends a cyclic, rather than sequential, approach to implementing this vision, including establishing a comprehensive governance framework, identifying key disease categories, enhancing non-communicable disease surveillance, prioritising diseases for elimination, and improving surveillance functions and infrastructure at all levels. It emphasises innovations in surveillance activities and strengthening human resources, laboratory infrastructure and community engagement. Successfully implementing these strategies positions India to become a leader in public health surveillance, exemplifying “Information for Action”. In the wake of China’s renewed emergence as a hub for respiratory illnesses, India faces a critical juncture to bolster its public health defences. The historical pattern of diseases originating from China, most recently the spate of respiratory conditions affecting children, casts a shadow of urgency over India’s public health strategy. The WHO’s scrutiny of these outbreaks underscores the global implications of localized health crises. India, mindful of the risks posed by its proximity and extensive travel ties with China, must harness this moment to elevate its public health surveillance to unprecedented levels. Public health, being a state subject in India, necessitates a synergetic approach between the Union and state governments. The NITI Aayog’s vision for 2035, which interlaces initiatives like Ayushman Bharat and the Integrated Disease Surveillance Programme, provides a robust blueprint for this collaborative effort. It’s paramount that India seizes this impetus to intensify its healthcare infrastructure and surveillance systems, ensuring equitable access to healthcare across its vast rural expanses. India must utilise innovation, technology, and effective governance to protect its citizens from immediate health threats and establish itself as a leader in global health security, proactively addressing challenges like those emerging from China’s recent disease outbreaks. The author is Officer on Special Duty, Research, Economic Advisory Council to the Prime Minister. He tweets @adityasinha004. Views expressed in the above piece are personal and solely that of the author. They do not necessarily reflect Firstpost_’s views._ Read all the Latest News, Trending News, Cricket News, Bollywood News, India News and Entertainment News here. Follow us on Facebook, Twitter and Instagram.